PM “most likely” needs a fan, says professor

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The prime minister is “extremely sick” – many coronavirus patients in need of intensive care requiring invasive ventilation, said an expert.

Boris Johnson was transferred Monday night to the critical unit at St Thomas Hospital as part of his ongoing treatment for Covid-19.

He was supposed to be conscious when he was transferred to intensive care around 7 p.m. as a precaution if he was to be ventilated to help him recover.

Boris Johnson chaired Covid-19 meetings in 10 Downing Street at No 11 Downing Street after isolating himself (Andrew Parsons / Crown Copyright / 10 Downing Street)

Derek Hill, professor of medical imaging at University College London (UCL), said PM could receive breathing aid known as continuous positive pressure (CPAP), which bridges the gap between an oxygen mask and full ventilation.

CPAP uses pressure to send a mixture of air and oxygen into the mouth at a constant rate, thereby increasing the amount of oxygen that enters the lungs.

But Professor Hill said that many Covid-19 patients end up “progressing to invasive ventilation.”

It is for people whose illness is so severe that they have trouble or are unable to breathe on their own.

A mechanical ventilator provides all of the patient’s breathing or supports their own breathing.

The patient is heavily sedated while a device called an endotracheal tube (ET) is guided through the mouth into the trachea.

A strong sedation then continues because having a tube in the throat can be very uncomfortable.

Patients can be fed at the same time through a tube entering the stomach through the nose.

Professor Hill said it was unclear whether Mr. Johnson was breathing alone or with the help of a ventilator.

He added: “One of the hallmarks of Covid-19 in all countries seems to be that many more men fall seriously ill than women – especially in the over 40 age group.

“We also know that people under the age of 60 seem to be more likely to recover from serious illness with Covid-19 than the elderly.

“But there is no doubt that this turn of events means that Boris Johnson is extremely ill.

“It illustrates three of the important health needs of Covid-19.

“First, many patients need help with breathing, and there is a shortage of mechanical ventilators that can do this – and in particular a shortage of high-quality intensive care ventilators best suited to Covid-19 patients who may need help breathing for more than one week.

“Second, Covid-19 patients need a huge amount of oxygen to help them breathe – which is potentially going to be lacking.

“Third, caring for people in critical care requires qualified staff, and New York experience has shown that finding enough qualified staff has been the biggest challenge.”

Police Officer Patrols Outside St Thomas Hospital (Aaron Chown / PA)

The Prime Minister, who celebrated his 55th birthday last June, could also take blood and throat samples according to indications given to doctors by the World Health Organization (WHO) last month.

The health agency says about 14% of Covid-19 patients will develop symptoms severe enough to require oxygen therapy and 5% will require intensive care treatment.

The Prime Minister should have already undergone several tests to check his oxygen levels, white blood cell count, and liver and kidney function before he was released from hospital after he was admitted to Covid-19, doctors said.

He is also likely to have an electrocardiogram to check his heart.

General practitioner Dr. Sarah Jarvis told the BBC shortly after his admission Sunday that Mr. Johnson would also have a chest x-ray and lung scan, especially if he was found to be having trouble breathing.

The death rate for people admitted to intensive care in the UK with Covid-19 has exceeded 50%, according to the latest figures.

The figure comes from data compiled by the National Critical Care Research and Audit Center (ICNARC) on a sample of 2,249 coronavirus patients.

The data showed that of the 690 patients in the sample with known care outcomes, 346 – 50.1% – died, while 344 were discharged.

The remaining 1,559 patients are said to be still in intensive care.

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